NPI | 1124546387 |
---|---|
Former Name | KAYLA JOY CULLISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM 382990) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-09-07 |
Last Update Date | 2020-01-31 |